GP patients expected to overplay symptoms on NHS chatbot to 'get appointment quicker'

Further pilots in North West London were dropped because of fears of patients 'gaming' the system

The chatbot app uses simulates a consultation to quiz patients about their symptoms (babylon)

A planned trial of a chat-bot app to free up doctors’ time was dropped after patients admitted they would manipulate the system by exaggerating symptoms to see a GP quicker.

NHS clinical commissioning groups in London had intended to use the Babylon healthcare app for its “symptom checker” function, which uses artificial intelligence to quiz patients about their symptoms.

It was hoped that this could free up GP time by reassuring patients when their symptoms don’t need medical intervention and directing them to a pharmacist or on how to self-care.

The app has already been trialled in parts of the capital as a possible alternative to the NHS 111 telephone service, where patients explain their symptoms to a call handler who directs them to the best service.

But the board of the North West London Collaboration of CCGs said early focus groups with patients revealed they were more interested in using it to jump the waiting list to see a GP.

The report said: “Patients who might use the app could mainly do so because they believed it would get them faster access to GP appointments.

“The focus groups had also commented that there is a risk of some people gaming the symptom checker to achieve a GP appointment.”

This could involve overstating symptoms to get an appointment sooner, and the CCGs’ board minutes reflect that this “significantly reduced the intended benefit”, so further testing wasn’t continued.

An earlier version of the board report had said the scheme had gone to a full test, as is happening in other parts of the NHS.

Babylon told the Health Service Journal, which first published the story, that the original report was “factually incorrect and deeply misleading”.

Babylon is one of a growing number of digital health start-ups offering a private GP service. It offers consultation via video and chat features for a monthly subscription.

The company is increasingly working within the NHS, either piloting its symptom app, or being contracted by GP practices to give patients access to its video consultations through its GP at Hand service.

Earlier this month, it announced GP at Hand would be rolling out across London and cities in other parts of the UK.

This caused concern amongst family doctor groups who point to disclaimers about the app’s suitability for pregnant women, or frail older patients. They accused it of “cherry picking” the healthy.

A spokesperson for Babylon said: “No pilot was ever carried out, nor any agreement signed with Babylon for such a pilot.

“Discussions were held after Babylon was selected in a competitive procurement exercise as the best technology to trial in GP practices across North West London. Subsequently, a decision was taken not to fund the pilot.”

A spokesperson for the CCGs said: “As part of the conversation, some people did indicate they would try and use the app to get a GP appointment quicker.

“As we were looking to see whether using the symptom checker would help reduce unnecessary GP attendance and help people get to the most appropriate care more quickly, a decision was made not to carry out a pilot at this time.”